Anatolian J Cardiol 2015; 15: E4-E7
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Figure 1. A-D. 2D TTE short-axis view revealed a peak pressure gradient over the right ventricular outflow tract of 30 mm Hg (Fig. 1A). 2D TEE short-axis view demonstrated bicuspid pulmonary valve (Fig. 1B and Video 1A, arrow). 3D TEE full-volume acquisition also showed bicuspid pulmonary valve (Fig. 1C and Video 1B, arrow). Transverse view of colored 3D volume-rendered CT angiography also demonstrated bicuspid pulmonary valve (Fig. 1D, arrow) Address for Correspondence: Dr. Servet Altay, Edirne Devlet Hastanesi Kardiyoloji Bölümü, Edirne-Türkiye Phone: +90 216 444 52 57 Fax: +90 216 337 97 19 E-mail: [email protected] Available Online Date: 23.10.2014 ©Copyright 2015 by Turkish Society of Cardiology - Available online at www.anakarder.com DOI:10.5152/akd.2014.5933
Multimodality imaging of isolated bicuspid pulmonary valve leading to pulmonary stenosis Isolated bicuspid pulmonary valve is a rare arterial valve anomaly with very few reports in the literature. It is usually in association with other congenital cardiac lesions. However, the true incidence of bicuspid pulmonary valve could be underestimated because of the difficulty in imaging pulmonary valve morphology with conventional two-dimensional transthoracic echocardiography. A 21-year-old man was admitted to our outpatient clinic for routine evaluation. Pansystolic murmur was heard on the left second intercostal space. The electrocardiogram showed normal sinus rhythm. The two-dimensional transthoracic echocardiography short-axis view revealed a peak pressure gradient over the right ventricular outflow tract of 30 mm Hg (Fig. 1A). The two-dimensional transesophageal echocardiography short-axis view demonstrated a bicuspid pulmonary valve (Fig. 1B and Video 1A, arrow). Three-dimensional transesophageal echocardiography full-volume acquisition also showed a bicuspid pulmonary valve (Fig. 1C and Video 1B, arrow). To clarify this pathology, we performed computed tomography (CT). The transverse view of colored three-dimensional volume-rendered CT angiography images also demonstrated a bicuspid pulmonary valve (Fig. 1D, arrow). We report here a case of isolated bicuspid pulmonary valve leading to pulmonary stenosis. There is difficulty in imaging pulmonary valve morphology. For this reason, the full spectrum of non-invasive cardiac imaging modalities should be performed in the diagnosis of bicuspid pulmonary valve. Multimodality imaging can help to diagnose this condition better. Cengiz Öztürk, Sait Demirkol, Mustafa Aparcı1, Sebahattin Sarı*, Uğur Bozlar*, Turgay Çelik, Atila İyisoy Departments of Cardiology and *Radiology, School of Medicine, Gülhane Military Medical Academy; Ankara-Turkey 1Department of Cardiology, Etimesgut Military Hospital; Ankara-Turkey
Address for Correspondence: Dr. Sait Demirkol, Gülhane Askeri Tıp Akademisi, Kardiyoloji Bölümü Tevfik Sağlam Sok., 06018 Etlik, Ankara-Türkiye Phone: +90 312 304 42 81 Fax: +90 312 304 42 50 E-mail: [email protected] Available Online Date: 21.01.2015 ©Copyright 2015 by Turkish Society of Cardiology - Available online at www.anakarder.com DOI:10.5152/akd.2015.5929
Coronary-cameral fistula in an asymptomatic adult patient The average frequency of coronary-cameral communication (CCC) is 0.09% in the population who undergoes coronary angiography. In addition, coronary-cameral fistula (CCF) constitutes 10% of all CCCs. CCF is probably very rare in adult patients, because the majority of them is detected and treated during childhood. Hereby, we present an asymptomatic adult patient with CCF who was diagnosed incidentally during a pre-operative cardiovascular examination for non-cardiac surgery. A 45-year-old female patient was referred to our outpatient clinic for a cardiovascular examination before an elective abdominal surgery. In her medical history, she had no cardiovascular symptoms. Physical examination revealed 1-2/6 apical systolic murmur.
Figure 1. Color flow Doppler jet of fistula at RV entrance
Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
A
E-page Original Images
B
C
E-5
D
Figure 1. A-D. 2D TTE short-axis view revealed a peak pressure gradient over the right ventricular outflow tract of 30 mm Hg (Fig. 1A). 2D TEE short-axis view demonstrated bicuspid pulmonary valve (Fig. 1B and Video 1A, arrow). 3D TEE full-volume acquisition also showed bicuspid pulmonary valve (Fig. 1C and Video 1B, arrow). Transverse view of colored 3D volume-rendered CT angiography also demonstrated bicuspid pulmonary valve (Fig. 1D, arrow) Address for Correspondence: Dr. Servet Altay, Edirne Devlet Hastanesi Kardiyoloji Bölümü, Edirne-Türkiye Phone: +90 216 444 52 57 Fax: +90 216 337 97 19 E-mail: [email protected] Available Online Date: 23.10.2014 ©Copyright 2015 by Turkish Society of Cardiology - Available online at www.anakarder.com DOI:10.5152/akd.2014.5933
Multimodality imaging of isolated bicuspid pulmonary valve leading to pulmonary stenosis Isolated bicuspid pulmonary valve is a rare arterial valve anomaly with very few reports in the literature. It is usually in association with other congenital cardiac lesions. However, the true incidence of bicuspid pulmonary valve could be underestimated because of the difficulty in imaging pulmonary valve morphology with conventional two-dimensional transthoracic echocardiography. A 21-year-old man was admitted to our outpatient clinic for routine evaluation. Pansystolic murmur was heard on the left second intercostal space. The electrocardiogram showed normal sinus rhythm. The two-dimensional transthoracic echocardiography short-axis view revealed a peak pressure gradient over the right ventricular outflow tract of 30 mm Hg (Fig. 1A). The two-dimensional transesophageal echocardiography short-axis view demonstrated a bicuspid pulmonary valve (Fig. 1B and Video 1A, arrow). Three-dimensional transesophageal echocardiography full-volume acquisition also showed a bicuspid pulmonary valve (Fig. 1C and Video 1B, arrow). To clarify this pathology, we performed computed tomography (CT). The transverse view of colored three-dimensional volume-rendered CT angiography images also demonstrated a bicuspid pulmonary valve (Fig. 1D, arrow). We report here a case of isolated bicuspid pulmonary valve leading to pulmonary stenosis. There is difficulty in imaging pulmonary valve morphology. For this reason, the full spectrum of non-invasive cardiac imaging modalities should be performed in the diagnosis of bicuspid pulmonary valve. Multimodality imaging can help to diagnose this condition better. Cengiz Öztürk, Sait Demirkol, Mustafa Aparcı1, Sebahattin Sarı*, Uğur Bozlar*, Turgay Çelik, Atila İyisoy Departments of Cardiology and *Radiology, School of Medicine, Gülhane Military Medical Academy; Ankara-Turkey 1Department of Cardiology, Etimesgut Military Hospital; Ankara-Turkey
Address for Correspondence: Dr. Sait Demirkol, Gülhane Askeri Tıp Akademisi, Kardiyoloji Bölümü Tevfik Sağlam Sok., 06018 Etlik, Ankara-Türkiye Phone: +90 312 304 42 81 Fax: +90 312 304 42 50 E-mail: [email protected] Available Online Date: 21.01.2015 ©Copyright 2015 by Turkish Society of Cardiology - Available online at www.anakarder.com DOI:10.5152/akd.2015.5929
Coronary-cameral fistula in an asymptomatic adult patient The average frequency of coronary-cameral communication (CCC) is 0.09% in the population who undergoes coronary angiography. In addition, coronary-cameral fistula (CCF) constitutes 10% of all CCCs. CCF is probably very rare in adult patients, because the majority of them is detected and treated during childhood. Hereby, we present an asymptomatic adult patient with CCF who was diagnosed incidentally during a pre-operative cardiovascular examination for non-cardiac surgery. A 45-year-old female patient was referred to our outpatient clinic for a cardiovascular examination before an elective abdominal surgery. In her medical history, she had no cardiovascular symptoms. Physical examination revealed 1-2/6 apical systolic murmur.
Figure 1. Color flow Doppler jet of fistula at RV entrance
Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of Aves Yayincilik Ltd. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
